For the Love of Nancy

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Transcript of For the Love of Nancy

For the Love of Nancy307.1Diagnostic CriteriaA. Restriction of energy intake relative to requirements, leading to a significantly low body weight in the content of age, sex, developmental trajectory, and physical health. Significantly low weight is defined as a weight that is less than minimally normal or, for children and adolescents, less than that minimally expected.

B. Intense fear of gaining weight or of becoming fat, or persistent behavior that interferes with weight gain, even though at a significantly low weight.

C. Disturbance in the way in which one’s body weight or shape is experienced, undue influence of body weight or shape on self-evaluation, or persistent lack of recognition of the seriousness of the current low body weight.

FemaleLate adolescentCaucasianTwo brothersIn-tact familyUpper-Middle classRecent high school graduate moving away for collegeGenesis Goma & Meredith RobieUniversity of Southern CaliforniaDr. Greg HendersonPsychopathology, November 10, 2014(National Association of Anorexia Nervosa and Associated Disorders, 2014)"Eating disorders have the highest mortality rate of any mental illness."Anorexia NervosaClient InformationOther Conditions That May Be a Focus of Clinical AttentionProblems Related to Family UpbringingV61.20 (Z62.820) Parent-Child Relational ProblemOther Problems Related to the Social EnvironmentV62.89 (Z60.0) Phase of Life ProblemSummary DiagnosisDifferential DiagnosisCyclothymic Disorder 301.13 (F34.0)Diagnostic CriteriaSpecify if: With anxious distress: The presence of at least two of the following symptoms during the majority of days of the current or most recent episode of mania, hypomanic, or depression: 1. Feeling keyed up or tense (yes)2. Feeling unusually restless (no)3. Difficulty concentrating because of worry (no)4. Fear that something awful may happen (yes)5. Feeling that the individual might lose control of himself or herself (yes)

Moderate: Three symptoms

Specify current severity: A. For at least 2 years (at least 1 year in children and adolescents) there have been numerous periods with hypomanic symptoms that do not meet criteria for a hypomanic episode and numerous periods with depressive symptoms that do not meet criteria for a major depressive episode. B. During the above 2-year period (1 year in children and adolescents), the hypomanic and depressive periods have been present for at least half the time and the individual has not been without the symptoms for more than 2 months at a time. C. Criteria for a major depressive, manic, or hypomanic episode have never been met. D. The symptoms in Criterion A are not better explained by schizoaffective disorder, schizophrenia, schizophreniform disorder, delusional disorder, or other specified or unspecified schizophrenia spectrum and other psychotic disorder. E. The symptoms are not attributable to the physiological effects of a substance of a substance (e.g. a drug of abuse, a medication) or another medical condition (e.g. hyperthyroidism). F. The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.

During the last 3 months, the individual has not engaged in recurrent episodes of binge eating or purging behavior (i.e., self-induced vomiting or the misuse of laxatives diuretics, or enemas). This subtype describes presentations in which weight loss is accomplished primarily through dieting, fasting, and/or excessive exercise.Specify whether:Restricting Type (F50.01)Specify current severity:Mild: BMI > or equal to 17 kg/m2

Moderate: BMI 16 - 16.99 kg/m2

Severe: BMI 15 - 15.99 kg/m2

Extreme: BMI < 15 kg/m2Nancy's BMI is 11.9Co-morbid DiagnosisSeparation Anxiety Disorder 309.21 (F93.0)A. Developmentally inappropriate and excessive fear or anxiety concerning separation from those to whom the individual is attached, as evidenced by at least three of the following:1. Recurrent excessive distress when anticipating or experiencing separation from home or from major attachment figures.

4. Persistent reluctance or refusal to go out, away from home, to school, to work, or elsewhere because of fear of separation.

5. Persistent and excessive fear of or reluctance about being alone or without major being near a major attachment figure.

B. The fear, anxiety, or avoidance is persistent, lasting at least 4 weeks in children and adolescents and typically 6 months or more in adults.

C. The disturbance causes clinically significant distress or impairment in social, academic, occupational, or other important areas o functioning.